Etiologies and Predictors of ST-Segment Elevation Myocardial Infarction
Korean Circulation Journal
;
: 370-376, 2013.
Article
in English
| WPRIM
| ID: wpr-198276
ABSTRACT
BACKGROUND AND OBJECTIVES:
Rapid diagnosis of ST-segment elevation myocardial infarction (STEMI) is essential for the appropriate management of patients. We investigated the prevalence, etiologies and predictors of false-positive diagnosis of STEMI and subsequent inappropriate catheterization laboratory activation in patients with presumptive diagnosis of STEMI. SUBJECTS ANDMETHODS:
Four hundred fifty-five consecutive patients (62+/-13 years, 345 males) with presumptive diagnosis of STEMI between August 2008 and November 2010 were included.RESULTS:
A false-positive diagnosis of STEMI was made in 34 patients (7.5%) with no indication of coronary artery lesion. Common causes for the false-positive diagnosis were coronary spasm in 10 patients, left ventricular hypertrophy in 5 patients, myocarditis in 4 patients, early repolarization in 3 patients, and previous myocardial infarction and stress-induced cardiomyopathy in 2 patients each. In multivariate logistic regression analysis, symptom-to-door time >12 hours {odds ratio (OR) 4.995, 95% confidence interval (CI) 1.384-18.030, p=0.014}, presenting symptom other than chest pain (OR 7.709, 95% CI 1.255-39.922, p=0.027), absence of Q wave (OR 9.082, CI 2.631-31.351, p<0.001) and absence of reciprocal changes on electrocardiography (ECG) (OR 17.987, CI 5.295-61.106, p<0.001) were independent predictors of false-positive diagnosis of STEMI.CONCLUSION:
In patients whom STEMI was planned for primary coronary intervention, the false-positive diagnosis of STEMI was not rare. Correct interpretation of ECGs and consideration of ST-segment elevation in conditions other than STEMI may reduce inappropriate catheterization laboratory activation.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Spasm
/
Chest Pain
/
Catheterization
/
Logistic Models
/
Prevalence
/
Hypertrophy, Left Ventricular
/
Coronary Vessels
/
Electrocardiography
/
False Positive Reactions
/
Catheters
Type of study:
Etiology study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Korean Circulation Journal
Year:
2013
Type:
Article
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